Skip to main content

Traumatic Maculopathy

  • Living reference work entry
  • First Online:
Albert and Jakobiec's Principles and Practice of Ophthalmology

Abstract

The retina, unique in its design and function, is a fragile neural tissue, easily injured and possessing only modest capabilities for repair. Understanding the diffuse nature of retinal injuries requires an appreciation for distinct mechanisms of trauma. The mechanisms of traumatic injury of the retina are numerous and can be categorized into those resulting from sharp or lacerating forces, those associated with blunt force (contusion or rupture), those resulting from acceleration or deceleration forces, and other more complex mechanisms including vascular and photic injuries. The most common traumatic retinopathies involve contusion-related closed globe injuries, which induce mechanical changes of the globe configuration from blunt impact. While our ability to manage severe ocular injuries has certainly improved in the past 50 years, involvement of the retina continues to be an ominous sign, portending a guarded visual prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

References

  1. Negrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5:143–69.

    Article  CAS  PubMed  Google Scholar 

  2. Kuhn F, Morris R, Witherspoon CD, Mann L. Epidemiology of blinding trauma in the United States eye injury registry. Ophthalmic Epidemiol. 2006;13:209–16.

    Article  PubMed  Google Scholar 

  3. Kuhn F. Ocular Traumatology. Berlin/Heidelberg: Springer; 2008.

    Google Scholar 

  4. Iftikhar M, et al. Changes in the incidence of eye trauma hospitalizations in the United States from 2001 through 2014. JAMA Ophthalmol. 2019;137:48–56.

    Article  PubMed  Google Scholar 

  5. Archer DB, Canavan YM. Contusional eye injuries: retinal and choroidal lesions. Aust J Ophthalmol. 1983;11:251–64.

    Article  CAS  PubMed  Google Scholar 

  6. Berlin R. Zur sogenannten Commotio retinae. Klin Monatsbl Augenheilkd. 1873;1:42–78.

    Google Scholar 

  7. Gass J. Stereoscopic atlas of macular diseases: diagnosis and treatment. St. Louis: Mosby; 1987.

    Google Scholar 

  8. Duke-Elder, S. System of ophthalmology, (1972).

    Google Scholar 

  9. Bastek JV, Foos RY, Heckenlively J. Traumatic pigmentary retinopathy. Am J Ophthalmol. 1981;92:621–4.

    Article  CAS  PubMed  Google Scholar 

  10. Cogan DG. Pseudoretinitis pigmentosa. Report of two traumatic cases of recent origin. Arch Ophthalmol. 1969;81:45–53.

    Article  CAS  PubMed  Google Scholar 

  11. Pulido JS, Blair NP. The blood-retinal barrier in Berlin’s edema. Retina. 1987;7:233–6.

    Article  CAS  PubMed  Google Scholar 

  12. Hart JC, Frank HJ. Retinal opacification after blunt non-perforating concussional injuries to the globe. A clinical and retinal fluorescein angiographic study. Trans Ophthalmol Soc U K. 1975;95:94–100.

    CAS  PubMed  Google Scholar 

  13. Ismail R, Tanner V, Williamson TH. Optical coherence tomography imaging of severe commotio retinae and associated macular hole. Br J Ophthalmol. 2002;86:473–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Bradley JL, et al. Ultra-high-resolution optical coherence tomographic findings in commotio retinae. Arch Ophthalmol. 2011;129:107–8.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Sipperley JO, Quigley HA, Gass DM. Traumatic retinopathy in primates. The explanation of commotio retinae. Arch Ophthalmol. 1978;96:2267–73.

    Article  CAS  PubMed  Google Scholar 

  16. Eagling EM. Ocular damage after blunt trauma to the eye. Its relationship to the nature of the injury. Br J Ophthalmol. 1974;58:126–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Aaberg T. Macular holes. Surv Ophthalmol. 1970;15:162.

    Google Scholar 

  18. Miller JB, Yonekawa Y, Eliott D, Vavvas DG. A review of traumatic macular hole: diagnosis and treatment. Int Ophthalmol Clin. 2013;53:59–67.

    Article  PubMed  Google Scholar 

  19. Gass J. Stereoscopic atlas of macular diseases. St. Louis: Mosby; 1970.

    Google Scholar 

  20. Huang J, Liu X, Wu Z, Sadda S. Comparison of full-thickness traumatic macular holes and idiopathic macular holes by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2010;248:1071–5.

    Article  PubMed  Google Scholar 

  21. Johnson RN, et al. Traumatic macular hole: observations, pathogenesis, and results of vitrectomy surgery. Ophthalmology. 2001;108:853–7.

    Article  CAS  PubMed  Google Scholar 

  22. Kuhn F, Morris R, Mester V, Witherspoon CD. Internal limiting membrane removal for traumatic macular holes. Ophthalmic Surg Lasers. 2001;32:308–15.

    CAS  PubMed  Google Scholar 

  23. Rubin JS, et al. Vitrectomy, fluid-gas exchange and transforming growth factor–beta-2 for the treatment of traumatic macular holes. Ophthalmology. 1995;102:1840–5.

    Article  CAS  PubMed  Google Scholar 

  24. Garcia-Arumi J, Corcostegui B, Cavero L, Sararols L. The role of vitreoretinal surgery in the treatment of posttraumatic macular hole. Retina. 1997;17:372–7.

    Article  CAS  PubMed  Google Scholar 

  25. Markham RH, Chignell AH. Retinal detachment due to macular holes. Br J Ophthalmol. 1981;65:423–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Aaberg TM, Blair CJ, Gass JD. Macular holes. Am J Ophthalmol. 1970;69:555–62.

    Article  CAS  PubMed  Google Scholar 

  27. Aguilar JP, Green WR. Choroidal rupture. A histopathologic study of 47 cases. Retina. 1984;4:269–75.

    Article  CAS  PubMed  Google Scholar 

  28. Graefe AV. Zwei Falle von Ruptur der Choroidia. Graefes Arch Ophthalmol. 1854;1:402.

    Google Scholar 

  29. Ament CS, et al. Predictors of visual outcome and choroidal neovascular membrane formation after traumatic choroidal rupture. Arch Ophthalmol. 2006;124:957–66.

    Article  PubMed  Google Scholar 

  30. Fuller B, Gitter KA. Traumatic choroidal rupture with late serous detachment of macula. Report of successful argon laser treatment. Arch Ophthalmol. 1973;89:354–5.

    Article  CAS  PubMed  Google Scholar 

  31. Harissi-Dagher M, et al. Photodynamic therapy in young patients with choroidal neovascularization following traumatic choroidal rupture. Am J Ophthalmol. 2005;139:726–8.

    Article  PubMed  Google Scholar 

  32. Elliot D. R.L.A. Issues in ocular trauma – nonpenetrating posterior segment trauma. Ophthalmol Clin North America. 1995;8:647–67.

    Google Scholar 

  33. Goldzieher W. Beitrag zur Pathologie der orbitalen Schussverletzungen. Z Augenh. 1901;6:277–85.

    Google Scholar 

  34. Asaria RH, Zaman A, Sullivan PM. Retinitis sclopeteria associated with airbag inflation. Br J Ophthalmol. 1999;83:1094–5.

    Article  CAS  PubMed  Google Scholar 

  35. Goerlitz-Jessen M, Ali MH, Grewal DS. Sclopetaria and spontaneous resolution of subretinal fluid. Ophthalmol Retina. 2019;3:325.

    Article  PubMed  Google Scholar 

  36. Martin DF, et al. Treatment and pathogenesis of traumatic chorioretinal rupture (sclopetaria). Am J Ophthalmol. 1994;117:190–200.

    Article  CAS  PubMed  Google Scholar 

  37. Richards RD, West CE, Meisels AA. Chorioretinitis sclopetaria. Trans Am Ophthalmol Soc. 1968;66:214–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Richards RD, West CE, Meisels AA. Chorioretinitis sclopetaria. Am J Ophthalmol. 1968;66:852–60.

    Article  CAS  PubMed  Google Scholar 

  39. Williams DF, Mieler WF, Williams GA. Posterior segment manifestations of ocular trauma. Retina. 1990;10(Suppl 1):S35–44.

    Article  PubMed  Google Scholar 

  40. Mungan NK. Update on shaken baby syndrome: ophthalmology. Curr Opin Ophthalmol. 2007;18:392–7.

    Article  PubMed  Google Scholar 

  41. Emerson MV, Jakobs E, Green WR. Ocular autopsy and histopathologic features of child abuse. Ophthalmology. 2007;114:1384–94.

    Article  PubMed  Google Scholar 

  42. Harley RD. Ocular manifestations of child abuse. J Pediatr Ophthalmol Strabismus. 1980;17:5–13.

    CAS  PubMed  Google Scholar 

  43. Wilkinson WS, Han DP, Rappley MD, Owings CL. Retinal hemorrhage predicts neurologic injury in the shaken baby syndrome. Arch Ophthalmol. 1989;107:1472–4.

    Article  CAS  PubMed  Google Scholar 

  44. Harcourt B, Hopkins D. Permanent chorioretinal lesions in childhood of suspected origin. Trans Ophthalmol Soc U K. 1973;93:199–205.

    CAS  PubMed  Google Scholar 

  45. Emerson MV, Pieramici DJ, Stoessel KM, Berreen JP, Gariano RF. Incidence and rate of disappearance of retinal hemorrhage in newborns. Ophthalmology. 2001;108:36–9.

    Article  CAS  PubMed  Google Scholar 

  46. Duane TD. Valsalva hemorrhagic retinopathy. Trans Am Ophthalmol Soc. 1972;70:298–313.

    CAS  PubMed  PubMed Central  Google Scholar 

  47. Markovits AS. Sudden visual loss associated with sexual activity. Arch Ophthalmol. 1996;114:106.

    Article  CAS  PubMed  Google Scholar 

  48. Ulbig MW, Mangouritsas G, Rothbacher HH, Hamilton AM, McHugh JD. Long-term results after drainage of premacular subhyaloid hemorrhage into the vitreous with a pulsed Nd:YAG laser. Arch Ophthalmol. 1998;116:1465–9.

    Article  CAS  PubMed  Google Scholar 

  49. Sahu DK, Namperumalsamy P, Kim R, Ravindran RD. Argon laser treatment for premacular hemorrhage. Retina (Philadelphia, PA). 1998;18:79–82.

    Article  CAS  Google Scholar 

  50. De Terson A. l’hemorrhagie dans le corps vitre au cours de l’hemorrhagie cerebrale. Clin Ophthalmol. 1900;6:309.

    Google Scholar 

  51. Shaw HJ, Landers MB III, Sydnor CF. The significance of intraocular hemorrhages due to subarachnoid hemorrhage. Ann Ophthalmol. 1977;9:1403–5.

    PubMed  Google Scholar 

  52. Khan SG, Frenkel M. Intravitreal hemorrhage associated with rapid increase in intracranial pressure (Terson’s syndrome). Am J Ophthalmol. 1975;80:37–43.

    Article  CAS  PubMed  Google Scholar 

  53. Muller PJ, Deck JH. Intraocular and optic nerve sheath hemorrhage in cases of sudden intracranial hypertension. J Neurosurg. 1974;41:160–6.

    Article  CAS  PubMed  Google Scholar 

  54. Toosi SH, Malton M. Terson’s syndrome–significance of ocular findings. Ann Ophthalmol. 1987;19:7–12.

    CAS  PubMed  Google Scholar 

  55. Weingeist TA, Goldman EJ, Folk JC, Packer AJ, Ossoinig KC. Terson’s syndrome. Clinicopathologic correlations. Ophthalmology. 1986;93:1435–42.

    Article  CAS  PubMed  Google Scholar 

  56. Velikay M, et al. Retinal detachment with severe proliferative vitreoretinopathy in Terson syndrome. Ophthalmology. 1994;101:35–7.

    Article  CAS  PubMed  Google Scholar 

  57. Kuhn F, Morris R, Witherspoon CD, Mester V. Terson syndrome. Results of vitrectomy and the significance of vitreous hemorrhage in patients with subarachnoid hemorrhage. Ophthalmology. 1998;105:472–7.

    Article  CAS  PubMed  Google Scholar 

  58. Clarkson JG, Flynn HW Jr, Daily MJ. Vitrectomy in Terson’s syndrome. Am J Ophthalmol. 1980;90:549–52.

    Article  CAS  PubMed  Google Scholar 

  59. Schultz PN, Sobol WM, Weingeist TA. Long-term visual outcome in Terson syndrome. Ophthalmology. 1991;98:1814–9.

    Article  CAS  PubMed  Google Scholar 

  60. Morris R, Kuhn F, Witherspoon CD, Mester V, Dooner J. Hemorrhagic macular cysts in Terson’s syndrome and its implications for macular surgery. Dev Ophthalmol. 1997;29:44–54.

    Article  CAS  PubMed  Google Scholar 

  61. Purtscher O. Angiopathia retinae traumatica. Lymphorrhagien des Augengrundes. Graefes Arch Clin Exp Ophthalmol. 1912;82:347–71.

    Article  Google Scholar 

  62. Burton TC. Unilateral Purtscher’s retinopathy. Ophthalmology. 1980;87:1096–105.

    Article  CAS  PubMed  Google Scholar 

  63. Miguel AI, Henriques F, Azevedo LF, Loureiro AJ, Maberley DA. Systematic review of Purtscher’s and Purtscher-like retinopathies. Eye (Lond). 2013;27:1–13.

    Article  CAS  Google Scholar 

  64. Kelley JS. Purtscher’s retinopathy related to chest compression by safety belts. Fluorescein angiographic findings. Am J Ophthalmol. 1972;74:278–83.

    Article  CAS  PubMed  Google Scholar 

  65. Jacob HS, Craddock PR, Hammerschmidt DE, Moldow CF. Complement-induced granulocyte aggregation: an unsuspected mechanism of disease. N Engl J Med. 1980;302:789–94.

    Article  CAS  PubMed  Google Scholar 

  66. Urbanek J. Uber Fettembolie des Auges. Graefes Arch Clin Exp Ophthalmol. 1934;131:147–73.

    Article  Google Scholar 

  67. Inkeles DM, Walsh JB. Retinal fat emboli as sequela to acute pancreatitis. Am J Ophthalmol. 1975;80:935–8.

    Article  CAS  PubMed  Google Scholar 

  68. Giani A, Deiro AP, Sabella P, Eandi CM. Spectral domain-optical coherence tomography and fundus autofluorescence findings in a case of purtscher-like retinopathy. Retin Cases Brief Rep. 2011;5:167–70.

    Article  PubMed  Google Scholar 

  69. Atabay C, Kansu T, Nurlu G. Late visual recovery after intravenous methylprednisolone treatment of Purtscher’s retinopathy. Ann Ophthalmol. 1993;25:330–3.

    CAS  PubMed  Google Scholar 

  70. Wang AG, Yen MY, Liu JH. Pathogenesis and neuroprotective treatment in Purtscher’s retinopathy. Jpn J Ophthalmol. 1998;42:318–22.

    Article  CAS  PubMed  Google Scholar 

  71. Edwards P, et al. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet. 2005;365:1957–9.

    Article  PubMed  Google Scholar 

  72. Ahmed Y, Schimel AM, Pathengay A, Colyer MH, Flynn HW Jr. Endophthalmitis following open-globe injuries. Eye (Lond). 2012;26:212–7.

    Article  CAS  Google Scholar 

  73. Bhagat N, Nagori S, Zarbin M. Post-traumatic infectious Endophthalmitis. Surv Ophthalmol. 2011;56:214–51.

    Article  PubMed  Google Scholar 

  74. Cunningham ET Jr, Kilmartin D, Agarwal M, Zierhut M. Sympathetic Ophthalmia. Ocul Immunol Inflamm. 2017;25:149–51.

    Article  PubMed  Google Scholar 

  75. Castiblanco CP, Adelman RA. Sympathetic ophthalmia. Graefes Arch Clin Exp Ophthalmol. 2009;247:289–302.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Fan, J., Bagheri, N., Pieramici, D.J. (2020). Traumatic Maculopathy. In: Albert, D., Miller, J., Azar, D., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-90495-5_120-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90495-5_120-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90495-5

  • Online ISBN: 978-3-319-90495-5

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics